II 

118TH CONGRESS 

2D SESSION S. 3 

To amend title XVIII of the Social Security Act to waive cost-sharing for 

advance care planning services, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 20 (legislative day, DECEMBER 16), 2024 

Mr. WARNER (for himself, Ms. COLLINS, Ms. BALDWIN, and Ms. KLOBUCHAR) introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to waive 

cost-sharing for advance care planning services, and for 

other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Improving Access to 

5 Advance Care Planning Act’’. 

6 SEC. 2. MEDICARE COVERAGE OF ADVANCE CARE PLAN7 NING SERVICES. 

8 (a) ADVANCE CARE PLANNING SERVICES DE9 FINED.—Section 1861 of the Social Security Act (42 


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1 U.S.C. 1395x) is amended by adding at the end the fol2 lowing new subsection: 

3 ‘‘(nnn) ADVANCE CARE PLANNING SERVICES.— 

4 ‘‘(1) IN GENERAL.—The term ‘advance care 

5 planning services’ means a visit between an eligible 

6 practitioner (as defined in paragraph (2)) enrolled 

7 under section 1866(j) and an individual, a family 

8 member of such individual, or a surrogate des9 ignated by such individual, to discuss— 

10 ‘‘(A) the health care preferences of such 

11 individual; 

12 ‘‘(B) future health care decisions that may 

13 need to be made by, or on behalf of, such indi14 vidual; and 

15 ‘‘(C) advance directives or other standard 

16 forms, which may be completed by, or on behalf 

17 of, such individual. 

18 ‘‘(2) ELIGIBLE PRACTITIONER.—For purposes 

19 of paragraph (1), the term ‘eligible practitioner’ 

20 means— 

21 ‘‘(A) a physician (as defined in subsection 

22 (r)); 

23 ‘‘(B) a physician assistant (as defined in 

24 subsection (aa)(5)); 


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1 ‘‘(C) a nurse practitioner (as defined in 

2 subsection (aa)(5)); 

3 ‘‘(D) a clinical nurse specialist (as defined 

4 in subsection (aa)(5)); or 

5 ‘‘(E) a clinical social worker (as defined in 

6 subsection (hh)(1)) who possesses— 

7 ‘‘(i) a relevant care planning certifi8 cation; or 

9 ‘‘(ii) experience providing care plan10 ning conversations or similar services, as 

11 defined by the Secretary.’’. 

12 (b) NO APPLICATION OF COINSURANCE OR DEDUCT13 IBLE UNDER PART B.— 

14 (1) AMOUNT.—Section 1833(a)(1) of the Social 

15 Security Act (42 U.S.C. 1395l(a)(1)) is amended— 

16 (A) in subparagraph (GG), by striking 

17 ‘‘and’’ at the end; and 

18 (B) in subparagraph (HH), by striking the 

19 semicolon at the end and inserting the fol20 lowing: ‘‘and (II) with respect to advance care 

21 planning services (as defined in section 

22 1861(nnn)) furnished on or after January 1, 

23 2026, the amounts paid shall be 100 percent of 

24 the lesser of the actual charge for the services 


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1 or the amount determined under the fee sched2 ule established under section 1848(b)’’. 

3 (2) WAIVER OF APPLICATION OF DEDUCT4 IBLE.—The first sentence of section 1833(b) of the 

5 Social Security Act (42 U.S.C. 1395l(b)) is amend6 ed— 

7 (A) by striking ‘‘, and (13)’’ and inserting 

8 ‘‘(13)’’; and 

9 (B) by striking ‘‘section 1861(n).’’ and in10 serting the following: ‘‘section 1861(n), and 

11 (14) such deductible shall not apply with re12 spect to advance care planning services (as de13 fined in section 1861(nnn)) furnished on or 

14 after January 1, 2026’’. 

15 (c) EFFECTIVE DATE.—The amendments made by 

16 this section shall apply to items and services furnished on 

17 or after January 1, 2026. 

18 SEC. 3. HHS PROVIDER OUTREACH. 

19 (a) OUTREACH.—The Secretary of Health and 

20 Human Services (in this section referred to as the ‘‘Sec21 retary’’) shall conduct outreach to physicians and appro22 priate non-physician practitioners participating under the 

23 Medicare program under title XVIII of the Social Security 

24 Act with respect to Medicare payment for advance care 

25 planning counseling services furnished to individuals to 


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1 discuss their health care preferences, identified by 

2 Healthcare Common Procedure Coding System (HCPCS) 

3 codes 99497 and 99498 (or any successor to such codes). 

4 Such outreach shall include a new, comprehensive, one5 time education initiative to inform such physicians and 

6 practitioners of the addition of such services as a covered 

7 benefit under the Medicare program, including the re8 quirements for eligibility for such services. 

9 (b) REPORT.—Not later than 1 year after the date 

10 of enactment of this Act, the Secretary shall submit to 

11 the Committee on Ways and Means and the Committee 

12 on Energy and Commerce of the House of Representatives 

13 and the Committee on Finance of the Senate a report on 

14 the outreach conducted under subsection (a). Such report 

15 shall include a description of the methods used for such 

16 outreach. 

17 SEC. 4. MEDPAC REPORT ON THE FURNISHING OF AD18 VANCE CARE PLANNING SERVICES AND THE 

19 USE OF ADVANCE CARE PLANNING CODES 

20 UNDER THE MEDICARE PROGRAM. 

21 (a) STUDY.—The Medicare Payment Advisory Com22 mission (in this section referred to as the ‘‘Commission’’) 

23 shall conduct a study on advance care planning under the 

24 Medicare program under title XVIII of the Social Security 

25 Act. Such study shall include an analysis of— 


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1 (1) the furnishing of advance care planning 

2 services to Medicare beneficiaries, including— 

3 (A) which providers are trained to provide 

4 such services; 

5 (B) which providers are eligible to provide 

6 such services under the Medicare program; 

7 (C) the length and frequency of the visits 

8 for furnishing such services; and 

9 (D) any barriers related to providers fur10 nishing, or beneficiaries being furnished, such 

11 services; 

12 (2) the use of advance care planning Current 

13 Procedural Terminology (CPT) codes to bill for the 

14 furnishing of advance care planning services to 

15 Medicare beneficiaries, including— 

16 (A) circumstances under which codes other 

17 than advance care planning CPT codes are used 

18 to bill for such services under the Medicare pro19 gram and why providers do not use advance 

20 care planning CPT codes; and 

21 (B) any barriers to providers using ad22 vance care planning CPT codes to bill for such 

23 services under the Medicare program; and 

24 (3) such other items determined appropriate by 

25 the Commission. 


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1 (b) REPORT.— 

2 (1) IN GENERAL.—Not later than June 30, 

3 2026, the Commission shall submit to the Com4 mittee on Ways and Means and the Committee on 

5 Energy and Commerce of the House of Representa6 tives and the Committee on Finance of the Senate 

7 a report on the study conducted under subsection 

8 (a), together with recommendations for such legisla9 tion and administrative action as the Commission 

10 determines appropriate. 

Æ 


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